Provider Demographics
NPI:1982846903
Name:FRANCIS J. COLLINI, MD, FACS, P.C.
Entity Type:Organization
Organization Name:FRANCIS J. COLLINI, MD, FACS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:COLLINI
Authorized Official - Suffix:
Authorized Official - Credentials:CASC RT RDMS, RDCS
Authorized Official - Phone:570-674-6525
Mailing Address - Street 1:1845 MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:SHAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18708-1482
Mailing Address - Country:US
Mailing Address - Phone:570-674-6525
Mailing Address - Fax:570-674-6520
Practice Address - Street 1:1845 MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:SHAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18708-1482
Practice Address - Country:US
Practice Address - Phone:570-674-6525
Practice Address - Fax:570-674-6520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA044972E208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA240003566OtherRAILROAD MEDICARE
PA073412OtherFIRST PRIORITY
PA001458571Medicaid
PA580391OtherBC/BS
PA001458571Medicaid